Paragastric Autonomic Neural Blockade as Part of Combined Anesthesia.

To evaluate the effect of early autonomic blockade on the consumption of remifentanil and halogenated anesthesia in the intraoperative period during laparoscopic sleeve gastrectomy.

Inclusion Criteria:-all adult patients scheduled for LSG at each participating institution.Exclusion Criteriathe inability to perform a PG-ANB because of anatomical difficultiesthe need for revisional surgerythe need for concomitant hiatal hernia repair or other surgical proceduresconversion to open surgical proceduresallergies to local anesthetics or medication described in the anesthesia protocolintraoperative complications (e.g., visceral or vascular perforations)anesthesia-related complications requiring admission to intensive care